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A new day in healthcare. Together, CVS Health and Aetna help people on their path to better health.

Account Consultant

Primary Location: High Point, North Carolina
Additional Locations: NC-High Point, OH-New Albany
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Description:
This position is located in office in High Point, NC.
  • The Account Consultant / Plan Sponsor Liaison will serve as the Single Point Of Contact (SPOC) for the customer’s human resources personnel (benefit coordinator, administrator, etc.) and respond, manage, and resolve escalated and complex global issues for Claims/Calls.
  • The successful candidate will hold true to our Aetna / CVS values.
  • This is an opportunity to be the first voice our customers will see and hear as we begin our partnership with them at Aetna / CVS.


Fundamental Components:
  • Work with our customer closely with our account management team and our Aetna One Advocate team.
  • Build strong relationships with all levels of their team.
  • Will communicate with any additional vendors the plan sponsor may use (internal or external) to ensure the customer and member needs are addressed and met.
  • Handle escalations from the client or customer and collaborate with dedicated Team Coaches and Clinical Staff on urgent/escalated member issues.
  • Track and trend client or customer specific issues and provide timely notification to the various stakeholders when necessary.
  • Complete plan sponsor specific training and refresher training as needed with the team; you will update any plan sponsor specific tools.
  • You must be familiar with Aetna Standard Policy and how to utilize ePolicies to locate required policy information.
  • Create and communicate plan sponsor specific reporting that is needed and requested from the client or customer.
  • This position must be able to reprocess non-complex claims and resolve escalated member inquiries.


Background Experience:
  • Previous experience with claim/call center environment.
  • Previous account management experience and/or Plan Sponsor Service experience.
  • Demonstrated strong leadership skills.
  • Strong communication skills (verbal, written, presentation).
  • Strong understanding of multiple aspects of the plans and products preferred.
  • Ability to work with cross-functional business units and vendors to support the customer's needs and promotes collaboration.
  • Strong project managements skills.
  • Demonstrated critical thinking and decision making skills.
  • Automatic adjudication knowledge.
  • Strong knowledge of health insurance standards.


Additional Job Information:
Demonstrates strong leadership skills.
Strong communication skills (verbal, written, presentation)
Strong understanding of multiple aspects of the plans and products preferred
Ability to work with cross-functional business units and vendors to support the customer’s needs; promotes collaboration among constituents and represents a professional image of the company.
Strong project management skills. Critical thinking and decision making skills.
Automatic adjudication knowledge (e.g., number of claims affected on on-standard plans, knowing when a benefit auto adjudicates).
Strong knowledge of health insurance standards.

Required Skills:
Leadership - Driving a Culture of Compliance, Service - Creating a Differentiated Service Experience, Service - Handling Service Challenges

Desired Skills:
Leadership - Collaborating for Results, Service - Providing Solutions to Constituent Needs, Service - Working Across Boundaries

Functional Skills:
Customer Service - Customer Service - Member Services - Traditional products

Technology Experience:
Desktop Tool - Microsoft PowerPoint, Desktop Tool - Microsoft Word

Potential Telework Position:
No

Percent of Travel Required:
10 - 25%

EEO Statement:
Aetna is an Equal Opportunity, Affirmative Action Employer

Benefit Eligibility:
Benefit eligibility may vary by position. Click here to review the benefits associated with this position.

Candidate Privacy Information:
Aetna takes our candidate's data privacy seriously. At no time will any Aetna recruiter or employee request any financial or personal information (Social Security Number, Credit card information for direct deposit, etc.) from you via e-mail. Any requests

Click To Review Our Benefits (PDF)

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